Combat Casualty Care Team (CCCT) Critical Wartime ......category of requirements links to the attainment of core practice, clinical currency, and KSA Threshold for medical personnel

Combat Casualty Care Team (CCCT) Critical Wartime Specialty List

Readiness Criteria Group (Corps): Medical CorpsReadiness Criteria Specialty: Surgery, General (Combined from: General Surgery/Colon and Rectal

Surgery)Navy Subspecialty Code/AQD or NEC 15C0 (15C0/15C1/6CE)

Skill Set Knowledge/Performance (Knowledge - Training/Course Testing Only; Performance - Includes

both Knowledge and Performance (Practical Application Test))

Training Course Name Course Identification Number (CIN)

Training Frequency(Frequency of certification and training renewal; e.g. "Per Cycle" or "Q36M")

Training Duration(Amount of time (in hours)

away from MTF that it takes to complete the

training)

Training Location Authoritative Data System

Joint Expeditionary Scope of Practice

(ESP)/Joint Metrics? Yes / No

Category-1:Core Practice/Clinical Currency - Fundamental training and skills, usually obtained through medical education and maintained through Medical Treatment Facility (MTF) experience and/or partnerships. This category of requirements links to the attainment of core practice, clinical currency, and KSA Threshold for medical personnel.

Board Eligible/Certified; Maintain clinical privileges for General Surgeon

Knowledge General Surgery Residency N/A Initial/Recertification N/A N/A Joint Centralized Credentials Quality Assurance System (JCCQAS)

Yes

Knowledge assessment (written exam) Knowledge Knowledge, Skills, and Abilities (KSA) Assessment

N/A 3 years 4 hours Navy Medicine Readiness and Training Command (NMRTC)

TBD Yes

Clinical Currency (Knowledge, Skills, and Abilities (KSA)) threshold 14,000

Performance N/A N/A Rolling Annual Measure N/A Navy Medicine Readiness and Training Command (NMRTC)

Military Health System Management Analysis and Reporting Tool (M2) - accessed through CarePoint

Yes

Category-2:Expeditionary Skills for Readiness/Readiness Currency - Combat Specialty Knowledge – Individual skills specific to operating in an expeditionary environment. Category 2 Readiness Criteria ensures transference of Category 1 skills to the expeditionary environment, including patient care during combat operations. Category 2 Readiness Criteria also includes general platform training requirements for an individual specialty across the potential operating environment to which the individual would be assigned. This category of requirements links to the attainment of readiness currency.

Advanced Trauma Life Support (ATLS) Performance ATLS 6A-C4C (ATLS) Q48M 40 hours San Antonio, TX Fleet Management & Planning System (FLTMPS)

Yes

Advanced Cardiac Life Support (ACLS) Performance ACLS MED-R-1500 Q24M 16 hours Navy Medicine Readiness and Training Command (NMRTC)

Fleet Management & Planning System (FLTMPS)

Combat Casualty Care Course (C4) Performance C4 B-6H-0001 Initial 216 hours Fort Sam Houston, TX Fleet Management & Planning System (FLTMPS)

Tactical Combat Care Course (TCCC) Performance TCCC B-300-4010 Q36M 72 hours Camp Pendleton, CA or Fort Sam Houston, TX


Emergency War Surgery (EWS), Advanced Surgical Skills for Exposure in Trauma (ASSET) course, or Advanced Surgical Skills for Exposure in Trauma (ASSET) plus (Expeditionary) course

Performance EWS, ASSET, or ASSET+

B-6A-1003 Initial 18 hours - 72 hours Various (Bethesda, MD; Fort Sam Houston, TX; San Diego, CA; Sacramento, CA)


Basic Endovascular Skills for Trauma (BEST) Performance BEST N/A N/A N/A Navy Medicine Readiness and Training Command (NMRTC)


Fundamentals of Critical Care Support (FCCS) Performance FCCS N/A N/A N/A Navy Medicine Readiness and Training Command (NMRTC)


Chemical, Biological, Radiological (CBR) Personal Protection and Decontamination - Expeditionary Medical Facilities (EMF) Platform Requirement

Knowledge CBR Personal Protection and Decontamination

A-494-0008 Initial 8 hours Gulfport, MS or Port Hueneme, CA or Mobile Training Team (MTT)


Surgery, General (Combined from: General Surgery/Colon and Rectal Surgery) Enclosures (1)Page 1 of 49


Category-3: Platform Training for Readiness - Readiness Proficiency/Operational Platform – Team/Unit-level training specific to a platform or unit to which a Service member is assigned. This category of requirements links to the attainment of readiness proficiency and, as such, joint interoperability.

Expeditionary Medical Facilities (EMF) Build Team Training Performance EMF Phase IIA B-300-2406 Per Cycle 40 hours Camp Pendleton, CA Fleet Management & Planning System (FLTMPS)

Expeditionary Medical Facilities (EMF) Field Training and Operational Readiness Exercise (ORE)

Performance EMF Phase IIB B-300-2407 Per Cycle 40 hours Camp Pendleton, CA Fleet Management & Planning System (FLTMPS)

Surgery, General (Combined from: General Surgery/Colon and Rectal Surgery) Enclosures (1)Page 2 of 49


Readiness Criteria Group (Corps): Medical CorpsReadiness Criteria Specialty: Orthopedic Surgery, GeneralNavy Subspecialty Code/AQD or NEC 15H0

Skill Set Knowledge/Performance (Knowledge - Training/Course Testing Only; Performance -

Includes both Knowledge and Performance (Practical Application Test))


Training Frequency(Frequency of

certification and training renewal; e.g. "Per Cycle"

or "Q36M")

Training Duration(Amount of time (in

hours) away from MTF that it takes to complete

the training)




Category-1:Core Practice/Clinical Currency – Fundamental training and skills, usually obtained through medical education and maintained through Medical Treatment Facility (MTF) experience and/or partnerships. This category of requirements links to the attainment of core practice, clinical currency, and KSA Threshold for medical personnel.

Board Eligible/Certified; maintain clinical privileges for an Orthopedic Surgeon

Knowledge American Board of Orthopedic Surgery (ABOS)

N/A Initial/ Recertification N/A N/A Joint Centralized Credentials Quality Assurance System (JCCQAS)

Yes

Clinical Currency Knowledge, Skills, and Abilities (KSA) threshold 35,000

Performance N/A N/A Rolling annual measure N/A NMRTC Military Health System Management Analysis and Reporting Tool (M2) - accessed through CarePoint

Yes

Category-2: Expeditionary Skills for Readiness/Readiness Currency - Combat Specialty Knowledge – Individual skills specific to operating in an expeditionary environment. Category 2 Readiness Criteria ensures transference of Category 1 skills to the expeditionary environment, including patient care during combat operations. Category 2 Readiness Criteria also includes general platform training requirements for an individual specialty across the potential operating environment to which the individual would be assigned. This category of requirements links to the attainment of readiness currency.

Combat Extremity Surgery Course Performance Combat Extremity Surgery Course

6A-A0128 Q48M 8-24 hours Funded by the Army, taught by a tri-service faculty;Society of Military Orthopedic Surgeons Annual Meeting and 2-3 courses/year in Miami


Yes

Advanced Trauma Life Support (ATLS) Performance ATLS 6A-C4C (ATLS) Per Cycle 40 hours DMRTI San Antonio, TX/ Can be delivered at select MTFs)


Yes

Emergency War Surgery (EWS) Performance EWS Course B-6A-1003 Initial 24 hours Fort Sam Houston, TX Fleet Management & Planning System (FLTMPS)

Yes

Chemical, Biological, Radiological, Nuclear, and Explosives (CBRNE) Emergency Preparedness Response Course (EMPRC) (Clinician) - Expeditionary Medical Facilities (EMF) Platform Requirement

Knowledge CBRNE EMPRC (Clinician)

DMRTI-US017 Q36M 8 hours Joint Knowledge Online (JKO)


Chemical, Biological, Radiological (CBR) Protective Equipment & Measures - Expeditionary Medical Facilities (EMF) Platform Requirement

Knowledge CBR Personal Protective Equipment And Measures

CNE-CBR-001 Q36M 8 hours Joint Knowledge Online (JKO)



Tactical Combat Care Course (TCCC) Performance TCCC Provider Training B-300-4010 Per Cycle 24 hours Camp Pendleton, CA or Fort Sam Houston, TX


Orthopedic Surgery, General Enclosures (1)Page 3 of 49




Expeditionary Medical Facilities (EMF) Field Training and ORE


Orthopedic Surgery, General Enclosures (1)Page 4 of 49


Readiness Criteria Group (Corps): Medical CorpsReadiness Criteria Specialty: Internal Medicine, Subspecialty (Critical Care)Navy Subspecialty Code/AQD or NEC 16R1/62C






away from MTF that it takes to complete the training)


Joint Expeditionary Scope of Practice (ESP)/Joint

Metrics? Yes / No

Category-1: Core Practice/Clinical Currency – Fundamental training and skills, usually obtained through medical education and maintained through Medical Treatment Facility (MTF) experience and/or partnerships. This category of requirements links to the attainment of core practice, clinical currency, and KSA Threshold for medical personnel.

Board Eligible/Certified; Maintain clinical privileges for Internal Medicine, Subspecialty Critical Care

Knowledge N/A N/A Initial/Recertification N/A One year program at Naval Medical Center San Diego (NMCSD), 2 year only Outservice

Joint Centralized Credentials Quality Assurance System (JCCQAS)

Yes

Inpatient Intensive Care Unit (ICU) threshold 50 admissions Performance N/A N/A Q24M 224 hours Navy Medicine Readiness and Training Command (NMRTC)


Yes

Knowledge, Skills, and Abilities (KSA) Critical Care Currency Threshold (68,000)

Performance KSA Clinical Currency Metric

N/A Rolling annual measure N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes




DMRTI-US017 Per Cycle 8 hours Joint Knowledge Online (JKO)



Knowledge CBR Personal Protective Equipment and Measures





A-494-0008 Once per career 8 hours Gulfport; Port Hueneme Fleet Management & Planning System (FLTMPS)


Expeditionary Medical Facilities (EMF) Build Team Training Performance EMF PHASE IIA B-300-2406 Per Cycle 40 hours Camp Pendleton, CA Fleet Management & Planning System (FLTMPS)

Internal Medicine, Subspecialty (Critical Care) Enclosures (1)Page 5 of 49



Performance EMF PHASE IIB B-300-2407 Per Cycle 40 hours Camp Pendleton, CA Fleet Management & Planning System (FLTMPS)

Internal Medicine, Subspecialty (Critical Care) Enclosures (1)Page 6 of 49


Readiness Criteria Group (Corps): Medical CorpsReadiness Criteria Specialty: Emergency Medicine, General Navy Subspecialty Code/AQD or NEC 16P0

Skill Set Knowledge/Performance (Knowledge - Training/Course Testing Only; Performance - Includes both Knowledge and Performance (Practical Application Test))



Training Duration(Amount of time (in hours) away from the MTF that it

takes to complete the training)



Metrics? Yes / No


Board eligible/certified; Maintain clinical privileges for Emergency Medicine, General

Knowledge Board Certification N/A Initial/Recertification N/A N/A Joint Centralized Credentials Quality Assurance System (JCCQAS)

Yes

Clinical Currency: Meets a minimum standard patient care threshold of 68,000 Knowledge Skills and Assessment points (KSAs) OR 768 Emergency Department patients/year (based on working a minimum of 48 weeks per year x 1 shift per week x 8 hour shift length x 2 patients per hour)

Performance Clinical Currency Knowledge, Skills, and Abilities (KSA) Threshold

N/A Rolling annual measure N/A Navy Medicine Readiness and Training Command (NMRTC) or Off-Duty Employment (ODE)


Yes

Procedure GroupingInsertion of a central venous catheter (or simulation) Performance N/A N/A Q4M N/A Navy Medicine Readiness

and Training Command (NMRTC)


Yes

Insertion of a chest tube (or simulation) Performance N/A N/A Q6M N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes

Insertion of an intra-osseous catheter (or simulation) Performance N/A N/A Q6M N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes

Perform a pericardiocentesis (or simulation) Performance N/A N/A Q12M N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes

Insert an endotracheal tube/intubation (or simulation) Performance N/A N/A Q1M (10/yr) N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes

Perform cardioversion/defibrilation (or simulation) Performance N/A N/A Q4M N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes

Perform emergency cricothyrotomy (or simulation) Performance N/A N/A Q6M N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes

Emergency Medicine, General Enclosures (1)Page 7 of 49


Perform procedural sedation (or simulation) Performance N/A N/A Q2M (5/yr) N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes

Perform eFAST ultrasound: cardiac, thoracic, abdominal (limited) (or simulation)

Performance N/A N/A Q1M (10/yr) N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes

Thoracotomy (or simulation) Performance N/A N/A Q12M N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes

Lateral Canthotomy (or simulation) Performance N/A N/A Q12M N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes

Blood or blood component transfusion (or simulation) Performance N/A N/A Q6M N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes

Fracture/dislocation reduction (or simulation) Performance N/A N/A Q2M (5/yr) N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes


Advanced Trauma Life Support (ATLS) Performance ATLS 6A-C4C (ATLS) Q48M 40 hours Defense Medical Human Resource System – internet (DMHRSi) San Antonio, TX (Can be delivered at select Navy Medicine Readiness and Training Commands (NMRTC))













Combat Casualty Care Course (C4) Performance C-4 B-6H-0001 Initial 56 hours Fort Sam Houston, TX Fleet Management & Planning System (FLTMPS)

Navy Trauma Training Course (NTTC) Performance NTTC B-6A-1013 Initial 232 hours LAC-USC Medical Center, 1200 North State Street, Room 6340, Los Angeles CA 90033












Readiness Criteria Group (Corps): Medical CorpsReadiness Criteria Specialty: Anesthesia, GeneralNavy Subspecialty Code/AQD or NEC 15B0









Metrics? Yes / No


Board Eligible/Certified; Maintain clinical privileges for an Anesthesiologist

Knowledge N/A N/A Initial/Recertification N/A N/A Joint Centralized Credentials Quality Assurance System (JCCQAS)

Yes

Clinical activity- preop assessment, intraoperative management and postop follow-up of at least 100 cases in 36 months

Performance N/A N/A Q36M 4,000 hours (0.5 FTE) Navy Medicine Readiness and Training Command (NMRTC) OR Simulation Based Training OR Approved Moonlighting.


Critical care management - management of ventilators, vasoactive medications of at least 20 cases in 3 years including general anesthetics with hemodynamic variations

Performance N/A N/A Q36M 56 hours - 112 hours annually

Navy Medicine Readiness and Training Command (NMRTC) OR Simulation Based Training OR Approved Moonlighting.



Trauma Management: Airways (7 Oct 15 JOA). Includes intubation of uncomplicated patient using such techniques or devices that are available in an austere location, including but not limited to awake intubation under topical anesthesia, in-line cervical stabilization, Eschmann stylet, and light wand. Excludes fiberoptic bronchoscope due to low likelihood of the device being available in an austere location. May be accomplished with human, animal model, or simulator.

Performance N/A N/A Q36M 112 hours Navy Medicine Readiness and Training Command (NMRTC) approved moonlighting


Yes

Trauma Management: Complex Trauma Cases (7 Oct 15 JOA).Including but not limited to major intra-abdominal, intrathoracic, and total joint replacement cases. Includes fluid resuscitation and blood replacement. Perform a goal of 10 cases.

Performance N/A N/A Q36M 112 hours Navy Medicine Readiness and Training Command (NMRTC) approved moonlighting


Yes

Anesthesia, General Enclosures (1)Page 10 of 49


Thorough understanding of Damage Control Resuscitation to include 1:1:1 blood component replacement, fresh whole blood and buddy transfusion, use of TXA and Ravia, lethal triad, types of shock, and principles of TIVA

Knowledge/ Performance N/A N/A Q36M 16 hours LA Trauma (or equivalent), Advanced Trauma Life Support (ATLS) but not Trauma Nursing Core Course (TNCC), pursue opportunity for Memorandum of Understanding (MOU)/External Resource Sharing Agreement (ERSA) sites for Trauma, Role 2 Light Maneuver team (R2LM)


Yes

Field Operations: Field Equipment, TIRO M (7 Oct 15 JOA). Anesthesia Machine: review Familiarization and Setup Guides at prescribed frequency. Service Manual available for additional information. When available, use Trio M anesthesia machine with human, animal model, or high fidelity simulator.

Knowledge/Performance N/A N/A Q36M 16 hours N/A Military Health System Management Analysis and Reporting Tool (M2) - accessed through CarePoint

Yes

Advanced Cardiac Life Support (ACLS) Performance ACLS MED-R-1500 Q24M 16 hours Locally delivered by unit. Fleet Management & Planning System (FLTMPS)

Yes

Pediatric Advanced Life Support (PALS) Performance PALS MED-R-1506 Q24M 16 hours Locally delivered by unit. Fleet Management & Planning System (FLTMPS)

Yes

Advanced Trauma Life Support (ATLS) Performance ATLS 6A-C4C (ATLS) Q48M 40 hours Navy Medicine Readiness and Training Command (NMRTC) OR Simulation Based Training OR Approved Moonlighting.


Tactical Combat Care Course (TCCC) Performance TCCC B-300-4010 Q36M 24 hours Navy Medicine Readiness and Training Command (NMRTC) OR Simulation Based Training OR Approved Moonlighting.


Anesthetic Considerations for NBC exposed patients Knowledge N/A N/A Q24M N/A Navy Medicine Readiness and Training Command (NMRTC)

TBD




















Readiness Criteria Group (Corps): Nurse CorpsReadiness Criteria Specialty: Certified Registered Nurse AnesthetistNavy Subspecialty Code/AQD or NEC 1972






or "Q36M")



the training)





Active, Valid, Unrestricted Registered Nurse (RN) and/or Advanced Practice Registered Nurse (APRN) issued by a U.S. State, Commonwealth, Territory, or District

Knowledge/Performance Applicable RN/APRN Licensure policy

Applicable RN/APRN Licensure policy - Continuing Nursing Education

Frequency of renewal set by applicable RN/APRN Licensure policy

Continuing Education Unit (CEU)s per applicable RN/APRN Licensure Requirements (~40 hours)

Naval Medical Readiness and Training command (NMRTC), Elsevier, Online CEUs, Conference Attendance

MTF, RN/APRN Licensure

Master of Science in Nursing (MSN) or Doctorate of Nursing Practice (DNP)

Knowledge/Performance Accredited Nursing School

Nursing School Curriculum

Initial N/A Anesthesia school accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA).


Board Certification from the relevant certification body for the given Advanced Practice Registered Nursing (APRN) Specialty(Fully privileged at Medical Treatment Facility (MTF) prior to deploying))

Knowledge/Performance Board Certification N/A Frequency of renewal set by relevant certification body

Continuing Education Unit (CEU)s per relevant certification body

Navy Medicine Readiness and Training Command (NMRTC), approved off duty employment Memorandum of understanding (MOU)/MOA, on-line CEU's, conference attendance


Yes

Active National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) certification Practice-During each four-year continued professional certification (CPC) cycle, the CRNA must be engaged in the practice of nurse anesthesia prior to the applicant’s CPC compliance expiration date and must submit an accurate record of practice.-The practice of nurse anesthesia may include clinical practice, nurse anesthesia-related administrative, educational or research activities, or a combination of two or more of such areas of practice. To be nurse anesthesia-related, activities must have as their primary objective and be directly related to the delivery of anesthesia care to patients or the improvement of delivery of anesthesia care to patients.-NBCRNA no longer requires the submission of information regarding the specific number of hours practiced during the CPC cycle, and therefore commensurate with board certification requirements, no specified quantity of clinical hours are delineated.

Performance NBRCRNA Certification N/A Initial/Recertification 8 hours N/A Joint Centralized Credentials Quality Assurance System (JCCQAS)

Yes

Certified Registered Nurse Anesthetist Enclosures (1)Page 13 of 49



Care of the complex trauma patient to include blunt and penetrating abdominal trauma, intrathoracic injuries, head, face, neck, and spine trauma, and traumatic limb amputation

Performance N/A N/A Q36M N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes

Clinical skills/knowledge encountered in the deployed environment to include advanced airway management, fluid resuscitation, blood product administration, aggressive hemodynamic instability management, cervical spine immobilization, and pain management

Knowledge/ Performance N/A N/A Q36M N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes

Thorough understanding of Damage Control Resuscitation to include 1:1:1 blood component replacement, fresh whole blood and buddy transfusion, use of TXA and rFVIIa, lethal triad, types of shock, and principles of TIVA


TBD Yes

Familiarization with deployed equipment to include but not limited to field anesthesia machine, TIVA, rapid infuser, IV and PCA pump, and transport ventilator


TBD Yes

Anesthetic Considerations for NBC exposed patients Knowledge N/A N/A Q24M N/A Navy Medicine Readiness and Training Command (NMRTC)

TBD












Advanced Trauma Life Support (ATLS) Performance ATLS 6A-C4C (ATLS) Q48M 40 hours Defense Medical Readiness Training (DMRTI) institute San Antonio, TX/ Can be delivered at select Military Health Systems


Yes



Pediatric Advanced Life Support (PALS) Performance PALS MED-R-1506 Q24M 16 hours Locally delivered by unit.


Yes







Readiness Criteria Group (Corps): Nurse CorpsReadiness Criteria Specialty: Emergency Trauma NursingNavy Subspecialty Code/AQD or NEC 1945





certification and training renewal; ( e.g. "Q36M")



the training)





Active, Valid, Unrestricted Registered Nurse (RN) and/or Advanced Practice Registered Nurse (APRN) issued by a U.S. State, Commonwealth, Territory, or District




Continuing Education Unit (CEU)s per applicable RN/APRN Licensure Requirements (~40 hours)

Navy Medicine Readiness & Training Command (NMRTC), Elsevier, CEU, Conference Attendance

NMFTC, RN/APRN Licensure

Bachelor of Science in Nursing (BSN) Knowledge/Performance Accredited Nursing School


Initial N/A Nursing School accredited by the Commission on Collegiate Nursing Education or the Accreditation Commission for Education in Nursing

Accreditation Commission for Education in Nursing, Inc. (hyperlink)

Yes

Maintains all practice requirements for active Emergency/Trauma Nurse certification and/or licensure and renewal.

Performance N/A N/A During initial orientation or once per duty station

N/A Navy Medicine Readiness & Training Command (NMRTC), TAA/Memorandum of understanding (MOU)/external resource sharing agreement (ERSAs), Regional Currency Site.


Yes

Completes Emergency Nursing Orientation at local command Knowledge/ Performance Elsevier Clinical Skills, Emergency Nursing Orientation (ENO) 3.0

N/A During initial orientation or once per duty station

8 hours Navy Medicine Readiness & Training Command (NMRTC), TAA/Memorandum of understanding (MOU)/external resource sharing agreement (ERSAs), Regional Currency Site.

Elsevier Clinical Skills online

Yes

Clinical Experience – 40 Direct Patient Care Hours Annually In A Level I/II Trauma Center

Knowledge/ Performance N/A N/A Annually 40 hours Navy Medicine Readiness & Training Command (NMRTC), TAA/Memorandum of understanding (MOU)/external resource sharing agreement (ERSAs), Regional Currency Site.

TBD Yes

12 Months Experience In The Specialty Knowledge/ Performance N/A N/A N/A N/A Navy Medicine Readiness & Training Command (NMRTC), TAA/Memorandum of understanding (MOU)/external resource sharing agreement (ERSAs), Regional Currency Site.

TBD Yes

Demonstrate Knowledge Of Joint Trauma System Clinical Practice Guidelines

Knowledge/ Performance Joint Trauma System Clinical Practice Guidelines; Navy Medicine Clinical Practice Guidelines

N/A As needed N/A Navy Medicine Readiness & Training Command (NMRTC), TAA/Memorandum of understanding (MOU)/external resource sharing agreement (ERSAs), Regional Currency Site.

TBD Yes

Emergency Trauma Nursing Enclosures (1)Page 16 of 49

https://www.acenursing.org/






Assess Patient Health StatusA. Completes primary/secondary patient assessmentB. Documents primary/ secondary assessment on Resuscitation Record Part I, Nursing Flow SheetC. Performs patient triage.

Knowledge/ Performance Elsevier Clinical Skills, Emergency Nursing Orientation (ENO) 3.0, Trauma-Neuro Critical Care (TNCC), Agents Transmissibles Non Conventionnels (ATNC)

N/A Q24M ATCN 16- 24 hours; TNCC 24 hours (Concurrent with time at Navy Medicine Readiness and Training Command (NMRTC))

Computer based training at NMRTC


Yes

Pediatric Patient Management: Identify key aspects of pediatric care:A. Assessment.B. Indications of volume deficit.C. Fluid Resuscitation.D. Indications of respiratory distress.E. Pain management/sedation.F. MedicationsG. Neonatal resuscitation.

Knowledge/ Performance Elsevier Clinical Skills, Emergency Nursing Orientation (ENO) 3.0, Pediatric Advanced Life Support (PALS)

N/A Q24M TBD Computer based training at Navy Medicine Readiness and Training Command (NMRTC)


Yes

Blast Injury (general)A. Optimizes/protects airway, breathing, circulation, cervical spine, body temperatureB. Describe the four levels of injury associated with a blast and problems associated with each level

Knowledge/ Performance Elsevier Clinical Skills, Emergency Nursing Orientation (ENO) 3.0

N/A Q36M or with PCS, whichever comes first

Self-paced, up to 40 hours



Gunshot woundA. Describes mechanisms of injury r/t GSWsB. Recognizes potential complications associated with GSWsC. Manages patient with GSW






2.5. Hemorrhagic ShockA. Recognizes clinical manifestations of hemorrhagic shockB. Initiates life-saving hemorrhage control interventions: direct pressure, pressure dressing, tourniquet, hemostatic dressingsC. Administers blood products during massive transfusion resuscitation.



Computer based training at MTF Elsevier Clinical Skills online

Yes



Neurological: Head TraumaA. Manages patient with mild traumatic brain injuryB. Manages patient with skull fractureC. Performs/interprets Glasgow Coma Scale



JTS Clinical Practice GuidelinesDirective-Type Memorandum (DTM) 09- 033, "Policy Guidance for Management of Concussion/Mild Traumatic Brain Injury in the Deployed SettingCervical and Thoracolumbar Spine Injury Cervical Spine Evaluation & Non-Surgical ManagementDefense Veterans Brain Injury CenterDVBIC TBI Screening Tool http://dvbic.dcoe.mil/audience/medical- providersBattlefield and Disaster Nursing Pocket Guide: NeurologicalSpinal Immobilization/. Cervical Collar ApplicationNeurological AssessmentDVBIC TBI Screening ToolMilitary Acute Concussion EvaluationHeat Related Injuries


Yes

Neurological: Spinal Cord/Vertebral TraumaA. Performs spinal precautions (maintains head/neck positioning, log rolling, total spine precautions)B. Performs spinal immobilization for cervical and thoracolumbar injuries (places cervical collar, spinal precautions, logrolling, and secures patient on backboard)C. Performs basic neurological assessment





Yes



Neurological: Heat Related InjuryA. Recognizes and provides therapies for: Heat illness, heat exhaustion, heat stroke





Yes

CardiothoracicA. Provides care related to tube thoracotomyB. LSI: Performs needle thoracotomy (decompression)C. Assists and prepares for thoracotomy



Closed Chest Drainage System, Needle Thoracotomy, AACN Procedure Manual for Critical Care , 6th Ed.Tactical Combat Casualty Care: TCCC Guidelines: Breathing Slides: Tactical Field CareEmergent Resuscitative Thoracotomy - 11 June 2012 JTS CPG TNCC


Yes

Orthopedic Trauma: FracturesA. Recognizes and manages patient with vertebral fractures, upper and lower extremity fractures, pelvic fracturesB. Performs external fixator pin careC. Performs color, motion, sensation (CMS) checks



JTS Clinical Practice GuidelinesCompartment Syndrome and Fasciotomy Pelvic Fracture CareAmputationBattlefield and Disaster Nursing Pocket Guide:RhabdomyolysisCrush InjuriesSoft Tissue TraumaCompartment SyndromeWound CareAmputationNegative Pressure Wound TherapyTactical Combat Casualty Care TCCC Guidelines: Bleeding Video: Combat GauzePPT: Tactical Field Care


Yes



Orthopedic Trauma: Compartment SyndromeA. Identifies signs and symptoms of extremity compartment syndromeB. Demonstrates emergent nursing management of extremity compartment syndromeC. Traction splint placement





Yes

Orthopedic Trauma: Extremity AmputationsA. Applies pressure dressingB. Positions residual limbC. Assess and manages





Yes

Soft Tissue TraumaA. Performs initial wound careB. Performs wet to moist dressings and wound packingC. Demonstrates use of negative pressure wound therapy (e.g., WoundVac)



JTS Clinical Practice GuidelinesInfection ControlManagement of War WoundsAmputationBattlefield and Disaster Nursing Pocket Guide:Soft Tissue TraumaWound CareAmputationNegative Pressure Wound Therapy


Yes

Ocular TraumaA. Performs basic ocular assessment (PERRL, general vision)B. Provides eye protection with appropriate devices (e.g., Fox shield)



JTS Clinical Practice GuidelinesInitial Care of Ocular and Adnexal InjuriesBattlefield and Disaster Nursing Pocket Guide:Ocular


Yes

VascularA. Recognizes signs/symptoms of vascular occlusion or compromiseB. LSI: Initiates immediate compression or tourniquet to control visible hemorrhage



Tactical Combat Casualty CareBleedingVideos: CAT (One/Two Handed Application)


Yes



BurnsA. Applies topical agents (e.g., silvadene, silver sulfamylon) to burnsB. Manages burn pain



JTS Clinical Practice Guidelines Burn careBattlefield and Disaster Nursing Pocket Guide:Burn Care TNCC


Yes

Hypothermia/Cold InjuriesA. Initiates therapies to prevent/minimize hypothermiaB. Recognizes hypothermiaC. Treats hypothermiaD. Manages frostbite injuries



JTS Clinical Practice GuidelinesHypothermia preventionBattlefield and Disaster Nursing Pocket Guide:Hypothermia Treatment


Yes

Genitourinary/Renal Trauma or Disorders: TraumaA. Recognizes signs and symptoms indicative of genitourinary/renal traumaB. Manages suprapubic catheterC. Assesses for contraindications to placement of urethral/bladder catheter



JTS Clinical Practice GuidelinesUrologic Trauma ManagementBattlefield and Disaster Nursing Pocket Guide:RhabdomyolysisCrush InjuriesRenal trauma


Yes

Genitourinary/Renal Trauma or Disorders: RhabdomyolysisA. Identifies at risk patientsB. Recognizes signs of RhabdomyolysisC. Implements therapies to prevent acute kidney injury associated with RhabdomyolysisD. Monitors and initiates therapies for acute fluid & electrolyte abnormalities associated with Rhabdomyolysis



JTS Clinical Practice GuidelinesUrologic Trauma ManagementBattlefield and Disaster Nursing Pocket Guide:RhabdomyolysisCrush Injuries Renal trauma


Yes

Assists with management of acute medical aspects of behavioral health conditionsA. At risk for self-harm, suicide, violenceB. Substance abuseC. Drug overdose (opioids, acetaminophen)D. Combat stress disorder (battle fatigue)E. Combat/ongoing/post- military operation stress disorder






Transport/evacuationA. Sets up NATO litter for transportB. Moves patient onto/off NATO litterC. Prepares patient (including equipment/supplies) for MEDEVAC or AE considering inflight care requirements and the stresses of flightD. Assists with loading/unloading transport vehicles (ambulance, MRAP- ambulance, AMBUS, helicopter, CH-60, CH-53, and MV-22)

Performance Elsevier Clinical Skills, Emergency Nursing Orientation (ENO) 3.0, Trauma-Neuro Critical Care (TNCC), Agents Transmissibles Non Conventionnels (ATNC)

N/A Q24M JECC - 80 hours; Flight Nurse - 120 hours

Aeromedical Evacuation Patient Considerations and Standards of Care. JTS Clinical Practice Guidelines Intra Theater Transfer and Transport


Yes

Pain/Anxiety ManagementA. Administers and monitors effect of analgesics, including intravenous morphine, fentanyl, dilaudidB. Sets up/administers medications via patient controlled analgesia (AMBIT Pain Pump)C. Care for patient receiving epidural analgesiaD. Care for patient with peripheral nerve blockE. Understands pharmacology and administers appropriate doses of medications including opioids, benzodiazepines, and Ketamine



JTS Clinical Practice Guidelines Management of Pain, Anxiety and Delirium


Yes

Blood/Blood ProductsAdministers the following productsA. Whole bloodB. Packed red blood cellsC. Deglycerolized bloodD. Fresh frozen plasmaE. CryoprecipitateF. Platelets



JTS Clinical Practice Guidelines Transfusion CPGs:Fresh whole blood transfusionFrozen Blood


Yes



Performs infection prevention & control measures by route of transmissionA. Endemic infections/diseaseB. Performs isolation for multidrug resistant organisms (e.g., Acinetobacter baumannii, Clostridium difficile)



JTS Clinical Practice GuidelinesInfection ControlBattlefield and Disaster Nursing Pocket GuideInfection Control/Infectious Diseases


Yes

Additional Info (Mass Casualty)A. Management of Victims in a Mass Casualty Incident Caused by a Terrorist BombingB. Epidemics After Natural DisastersC. Military Medicine in Humanitarian MissionsD. Centers for Disease Control: Emergency Preparedness and Response

Knowledge/ Performance Emergency Preparedness Response Course (EPRC) - Clinician Course

DMRTI - US017 Q36M or with PCS, whichever comes first.

Self-paced JKO Elsevier Clinical Skills online

Emergency/ Trauma Nurse Specific ItemsPerforms Emergency Nursing Care in Deployment with the Following Types of Injuries

Blast Lung InjuryA. Recognizes signs/symptoms of blast lung injuryB. Explainsventilation/oxygenation strategy for patient with blast lung injury

Knowledge Elsevier Clinical Skills, Emergency Nursing Orientation (ENO) 3.0





Soft Tissue TraumaA. Initial evaluation and resuscitationB. Role of resuscitative thoracotomyC. Triage considerationsD. Preoperative lab/imaging studiesE. Intraosseous placement



JTS Clinical Practice GuidelinesHigh Bilateral AmputationsDamage Control ResuscitationJTS Clinical Practice Guidelines Wartime Vascular InjuryIntraosseous Access, Emergency Nursing Procedures , 4th Ed.


Yes

Neurological Injury: Severe Traumatic Brain InjuryA. Manages patient requiring intracranial pressure monitoring/intraventricular drainage deviceB. Manages patient with increased ICP/decreased CPP



JTS Clinical Practice GuidelinesManagement of Patients with Severe Head TraumaNeurosurgical ManagementCatastrophic CareDefense Center of Excellence for Psychological Health & Traumatic Brain Injury [“For Health Professionals” section] http://www.dcoe.health.mil/Intracranial Pressure Monitoring,Emergency Nursing Core Curriculum, 6th Ed.


Yes

Neurological Injury: Mild Traumatic Brain InjuryA. Manages patient with a concussion Concussion Management Algorithm.

Knowledge Elsevier Clinical Skills, Emergency Nursing Orientation (ENO) 3.0, Trauma-Neuro Critical Care (TNCC), Agents Transmissibles Non Conventionnels (ATNC)


JTS Clinical Practice GuidelinesDCoE Concussion Management Algorithm CardsBattlefield and Disaster Nursing Pocket GuideNeurologicalVacuum Spine Board


Yes

Neurological Injury: Spinal Cord InjuryA. Places and secures patient in spinal immobilization to include C-collar (e.g. long spine board or vacuum spine board).

Performance Elsevier Clinical Skills, Emergency Nursing Orientation (ENO) 3.0, Trauma-Neuro Critical Care (TNCC), Agents Transmissibles Non Conventionnels (ATNC)


JTS Clinical Practice GuidelinesCervical Spine Evaluation & Non- Surgical ManagementCervical and Thoracolumbar Spine Injury


Yes



BurnsA. Estimate depth of burn/TBSA burnedB. Administer IV fluids based on BSA burnedC. Documents intake/output on burn resuscitation flow sheetD. Performs burn wound managementE. Manages burn painF. Assists with acute care of patients with the following types of burns: electrical, inhalation, chemical, white phosphorus, petroleum burns and carbon monoxide poisoningG. Administer prophylaxis medicationsH. Recognizes emergence burn syndromes: eschar and extremity/abdominal compartment



JTS Clinical Practice GuidelinesBurn CareInhalation Injury and Toxic Industrial ChemicalsBattlefield and Disaster Nursing Pocket Guide,BurnsAdvanced Burn Life Support Course Burn Trauma. Emergency Nursing Core Curriculum, 6th Ed. TNCC


Yes

Pulmonary/thoracic injuries/disordersA. Pulmonary/thoracic blunt and penetrating trauma, toxic inhalation (chlorine, hydrofluoric acid)B. Manages patient with open/tension pneumothoraxC. hemothoraxD. Manages patient with flail chestE. Needle thoracentesis






Cardiac injuryA. Blunt cardiac trauma (cardiac contusion)B. Cardiac tamponadeC. Aortic injuries






Abdominal TraumaA. Prepare for/assist with interventions1) FAST, resuscitation, CT, prepares patient for transfer to OR2) Pelvic splintB. Abdominal compartment syndrome1) Identifies patients at increased risk for intraabdominal hypertension/abdominal compartment syndrome



JTTS Clinical Practice GuidelinesPelvic Fracture CareBlunt abdominal traumaBattlefield and Disaster Nursing Pocket Guide: AbdominalGenitourinary/RenalPelvic Splinting, Emergency Nursing Procedures,4th Ed.Abdominal and Urologic Trauma,Emergency Nursing Core Curriculum, 6th Ed.TNCC


Yes

Otologic InjuryA. Identifies patients at risk for otologic blast injuryB. Assists with care of patient with otologic

Knowledge/Performance

Elsevier Clinical Skills, Emergency Nursing Orientation (ENO) 3.0, Trauma-Neuro Critical Care (TNCC), Agents Transmissibles Non Conventionnels (ATNC)


JTS Clinical Practice GuidelinesAcoustic Trauma and Hearing LossBattlefield and Disaster Nursing Pocket GuideOtologic Injury TNCC


Yes

Ocular and Maxillofacial TraumaA. Identifies lacerated or ruptured globeB. Identifies risk of airway management with maxillofacial trauma



JTS Clinical Practice GuidelinesInitial Care of Ocular and Adnexal InjuriesTrauma Airway ManagementRapid Sequence Intubation, Emergency Nursing Procedures , 4th Ed. TNCC


Yes



Pediatric Patients: Emergencies, IV access; fluid and medication administration; airway management, pediatric trauma and resuscitation

Knowledge/ Performance Elsevier Clinical Skills, Emergency Nursing Orientation (ENO) 3.0, Trauma-Neuro Critical Care (TNCC), Agents Transmissible Non Conventionnels (ATNC)


PALS Emergency Nursing Pediatric Course (ENPC)Battlefield and Disaster Nursing Pocket Guide,General pediatric considerationsPediatric - medicationsPediatric vital signsPediatric fluid resuscitationPediatric burn fluid resuscitationPediatric pain/sedation managementNeonatal – immediate care of newbornNeonatal resuscitationPediatric – stresses of flightBorden InstitutePediatric Surgery and Medicine in Harsh Environments (revised 2013)


Yes

Blood/Blood Product Administration: Administers the following products:A. Fresh warm whole bloodB. Recombinant Factor VIIa (rFVIIa)C. Tranexamic Acid (TXA)D. Administers massive transfusion



JTS Clinical Practice GuidelinesFresh whole blood transfusionFrozen BloodDamage Control Resuscitation at Level IIb/III Treatment FacilitiesBattlefield and Disaster Nursing Pocket GuideMassive transfusionBlood products


Yes

Aeromedical Evacuation/Critical Care TransportPrepares patient (including equipment/supplies) for CCATT considering inflight care requirements and stresses of flight

Knowledge/ Performance Joint Enroute Care Course (JECC), USAF Flight Nurse Course, Critical Care Air Transport (CCAT)

JOINT ENROUTE CARE COURSE (6A-F12/300-F26)

Q24M ATCN 16- 24 hours; TNCC 24 hours (Concurrent with time at Navy Medicine Readiness and Training Command (NMRTC))

JTS Clinical Practice GuidelinesIntratester Transfer and Transport of Level II and III Critical Care Trauma PatientsBattlefield and Disaster Nursing Pocket Guide,Transport


Yes

Pain/Anxiety ManagementA. Administers and monitors effect of analgesics, including intravenous morphine, fentanyl, dilaudidB. Administers and monitors effect of sedatives including propofol, midazolam, ketamineC. Sets up/administers medications via patient controlled analgesia (AMBIT Pain Pump)D. Assess for sedation level using RASS scaleE. Performs sedations vacation for mechanically ventilated patientsF. Administers and monitors effects of neuromuscular blockade



JTS Clinical Practice GuidelinesManagement of Pain, Anxiety and DeliriumBattlefield and Disaster Nursing Pocket GuidePain ManagementAeromedical Evacuation Considerations for Patients with Epidural Infusion or Peripheral Nerve Block Patient-Controlled Analgesia Ramsey Sedation Score Richmond Agitation Score Scale


Yes

EquipmentA.IV pumps (e.g. triple channel pump, syringe pump)B.Patient monitor/defibrillator (e.g. Propaq MD)C.Intraosseous access devices (e.g. EZ-IO)D.Blood/fluid warmer (e.g. Belmont Buddy Lite)E.Blood/fluid rapid infuser (e.g. Belmont Rapid Infuser)F.Chest tube drainage systems including autotransfusion (e.g. Atrium)G.Patient warming systems (e.g. Bair Hugger)H.Pneumatic tourniquetI.Ventilator (e.g. Zoll 731)J.Suction units (e.g. Impact suction)

Knowledge/ Performance Individual equipment training, just in time training

N/A Q36M or upon deployment, whichever comes first

Self-paced Navy Medicine Readiness and Training Command (NMRTC)


Advanced Life Support (ALS) Performance ALS MED-R-1500 Q24M 16 hours Locally delivered by unit. Fleet Management & Planning System (FLTMPS)

Yes

Basic Life Support (BLS) Knowledge/ Performance BLS MED-R-1503 Q24M 24 hours Navy Medicine Readiness and Training Command (NMRTC)




Pediatric Advanced Life Support (PALS) Knowledge/ Performance PALS N/A Q24M 24 hours to 48 hours Navy Medicine Readiness and Training Command (NMRTC)


Trauma Nurse Core Course (TNCC) Performance TNCC 6A-C4C(TNCC) Q48M 72 hours DMRTI San Antonio, TX/ Can be delivered at select MTFs)


Yes

Navy Trauma Training Center (NTTC) Performance NTTC B-6A-1013 Initial 232 hours LAC-USC Medical Center, 1200 North State Street, Room 6340, Los Angeles CA 90033


Yes


Knowledge CBRNE EMPRC (Clinician) Short Course

DMRTI-US017 Q36M 8 hours JKO Fleet Management & Planning System (FLTMPS)





*Care includes all phases of the nursing process (assessment, planning, implementation and evaluation). Additionally, care includes the correct set up and performance of monitoring technologies and the integration of these data into the plan of care.

*A common training source for all competencies is: Everyday work experience validated by supervisor/instructor; approved off- duty employment; Trauma Nursing Core Course (TNCC); Advanced Trauma Care for Nurses (ATCN); CCRN certification; C-STARS; CCATT, ACLS. Other training resources include: Simulated mannequin/training workshops; ARMs.



Readiness Criteria Group (Corps): Nurse CorpsReadiness Criteria Specialty: Critical Care NursingNavy Subspecialty Code/AQD or NEC 1960






or "Q36M")



the training)





Active, Valid, Unrestricted Registered Nurse (RN) and/or Advanced Practice Registered Nurse (APRN) issed by a U.S. State, Commonwealth, Territory, or District




40 hours Navy Medicine Readiness and Training Command (NMRTC), Elsevier, Online CEUs, Conference Attendance

NMRTC, RN/APRN Licensure

Master of Science in Nursing (MSN) or Doctorate of Nursing Practice (DNP)

Knowledge/Performance Accredited Nursing School


Initial N/A Nursing School accredited by the Commission on Collegiate Nursing Education or the Accreditation Commission for Education in Nursing

Accreditation Commission for Education in Nursing

Board Certification from the relevant certification body for the given APRN Specialty(Fully privileged at Navy Medicine Readiness and Training Command (NMRTC) prior to deploying))

Knowledge/Performance Board Certification N/A Frequency of renewal set by relevant certifcation body

Continuing Education Unit (CEU) per relevant certification body

NMRTC, approved off duty employment MOU/MOA, on-line CEU's, conference attendance


Yes

Foundational Clinical Skills: Complete Unit Orientation and current in Annual Competencies; 1960 Navy NC Critical Care Core Competency assigned on Elsevier Clinical Skills Website.

Knowledge/ Performance N/A N/A 36M or with PCS, whichever comes first

N/A N/A Elsevier Clinical Skills online

Yes

Foundational Clinical Skills: Complete American Association of Critical Care Nurses (AACN) Essentials of Critical Care Orientation (ECCO) assigned online at the AACN learning management system (LMS) website.

Knowledge/ Performance ECCO (current version) N/A One-time 40 hours AACN LMS website Officer Data Card (ODC)/Fleet Management & Planning System (FLTMPS)


Assess Patient Health StatusA. Completes primary/secondary patient assessmentB. Documents primary/ secondary assessment on Resuscitation Record Part I, Nursing Flow SheetC. Performs patient triage.

Performance TBD N/A 36M or with PCS, whichever comes first

N/A Navy E-Learning Proposed Relias Navy E-Learning created course.

Yes

Critical Care Nursing Enclosures (1)Page 26 of 49





Pediatric Patient Management: Identify key aspects of pediatric care:A. Assessment.B. Indications of volume deficit.C. Fluid Resuscitation.D. Indications of respiratory distress.E. Pain management/sedation.F. MedicationsG. Neonatal resuscitation.

Knowledge TBD N/A 36M or with PCS, whichever comes first


Yes

Performs Nursing Care in Deployment with the Following Types of Injuries

Blast Injury (general)A. Optimizes/protects airway, breathing, circulation, cervical spine, body temperatureB. Describe the four levels of injury associated with a blast and problems associated with each level

Knowledge/ Performance TBD N/A 36M or with Permanent change of station(PCS), whichever comes first


Gunshot woundA. Describes mechanisms of injury r/t GSWsB. Recognizes potential complications associated with GSWsC. Manages patient with GSW



Hemorrhagic ShockA. Recognizes clinical manifestations of hemorrhagic shockB. Initiates life-saving hemorrhage control interventions: direct pressure, pressure dressing, tourniquet, hemostatic dressingsC. Administers blood products during massive transfusion resuscitation.



Yes

Neurological: Head TraumaA. Manages patient with mild traumatic brain injuryB. Manages patient with skull fractureC. Performs/interprets Glasgow Coma Scale



Yes

Neurological: Spinal Cord/Vertebral TraumaA. Performs spinal precautions (maintains head/neck positioning, log rolling, total spine precautions)B. Performs spinal immobilization for cervical and thoracolumbar injuries (places cervical collar, spinal precautions, logrolling, and secures patient on backboard)C. Performs basic neurological assessment



Yes

Neurological: Heat Related InjuryA. Recognizes and provides therapies for: Heat illness, heat exhaustion, heat stroke



Yes

CardiothoracicA. Provides care related to tube thoracotomyB. LSI: Performs needle thoracotomy (decompression)



Yes

Orthopedic Trauma: FracturesA. Recognizes and manages patient with vertebral fractures, upper and lower extremity fractures, pelvic fracturesB. Performs external fixator pin careC. Performs color, motion, sensation (CMS) checks



Yes

Orthopedic Trauma: Compartment SyndromeA. Identifies signs and symptoms of extremity compartment syndromeB. Demonstrates emergent nursing management of extremity compartment syndrome





Orthopedic Trauma: Extremity AmputationsA. Applies pressure dressingB. Positions residual limbC. Assess and manages



Yes

Soft Tissue TraumaA. Performs initial wound careB. Performs wet to moist dressings and wound packingC. Demonstrates use of negative pressure wound therapy (e.g., WoundVac)



Yes

Ocular TraumaA. Performs basic ocular assessment (PERRL, general vision)B. Provides eye protection with appropriate devices (e.g., Fox shield)



Yes

VascularA. Recognizes signs/symptoms of vascular occlusion or compromiseB. LSI: Initiates immediate compression or tourniquet to control visible hemorrhage



Yes

BurnsA. Applies topical agents (e.g., silvadene, silver sulfamylon) to burnsB. Manages burn pain



Yes

Hypothermia/Cold InjuriesA. Initiates therapies to prevent/minimize hypothermiaB. Recognizes hypothermiaC. Treats hypothermiaD. Manages frostbite injuries



Yes

Genitourinary/Renal Trauma or Disorders: TraumaA. Recognizes signs and symptoms indicative of genitourinary/renal traumaB. Manages suprapubic catheterC. Assesses for contraindications to placement of urethral/bladder catheter



Yes

Genitourinary/Renal Trauma or Disorders: RhabdomyolysisA. Identifies at risk patientsB. Recognizes signs of RhabdomyolysisC. Implements therapies to prevent acute kidney injury associated with RhabdomyolysisD. Monitors and initiates therapies for acute fluid & electrolyte abnormalities associated with Rhabdomyolysis



Yes

Assists with management of acute medical aspects of behavioral health conditionsA. At risk for self-harm, suicide, violenceB. Substance abuseC. Drug overdose (opioids, acetaminophen)D. Combat stress disorder (battle fatigue)E. Combat/ongoing/post- military operation stress disorder



Provides using Care in Deployed Location for the Following IssuesTransport/evacuationA. Setups NATO litter for transportB. Moves patient onto/off NATO litterC. Prepares patient (including equipment/supplies) for MEDEVAC considering inflight care requirements and the stresses of flightD. Assists with loading/unloading transport vehicles (ambulance, MRAP- ambulance, AMBUS, helicopter)





Pain/Anxiety ManagementA. Administers and monitors effect of analgesics, including intravenous morphine, fentanyl, dilaudidB. Sets up/administers medications via patient controlled analgesia (AMBIT Pain Pump)C. Care for patient receiving epidural analgesiaD. Care for patient with peripheral nerve block



Yes

Blood/Blood ProductsAdministers the following productsA. Whole bloodB. Packed red blood cellsC. Deglycerolized bloodD. Fresh frozen plasmaE. CryoprecipitateF. Platelets



Yes

Performs infection prevention & control measures by route of transmissionA. Endemic infections/diseaseB. Performs isolation for multidrug resistant organisms (e.g., Acinetobacter baumannii, Clostridium difficile)



Yes

EquipmentA. Triple channel IV pumpB. PCA pump (e.g., AMBIT Pain Pump)C. Portable lab equipment (e.g., IStat machineD. Fluid warmer (e.g., Level 1/Belmont Rapid infuser)E. Wound vacuum (e.g., KCI wound vac)F. Chest tube drainage system - Adult/pediatric (e.g., Atrium)G. Bair HuggerH. Intracranial Pressure Monitoring Device – Intraventricular Drainage Device



Additional Info (Mass Casualty)A. Management of Victims in a Mass Casualty Incident Caused by a Terrorist BombingB. Epidemics After Natural DisastersC. Military Medicine in Humanitarian MissionsD. Centers for Disease Control: Emergency Preparedness and Response



Critical Care Nurse Specific ItemsPerforms Critical Care Nursing Care in Deployment with the Following Types of Injuries

Blast Lung InjuryA. Recognizes signs/symptoms of blast lung injuryB. Explainsventilation/oxygenation strategy for patient with blast lung injury

Knowledge TBD N/A 36M or with Permanent change of station(PCS), whichever comes first


Soft Tissue TraumaA. Intracompartmental pressure monitoringB. Performs injured extremity index



Yes

Neurological Injury: Severe Traumatic Brain InjuryA. Manages patient requiring intracranial pressure monitoring/intraventricular drainage deviceB. Manages patient with increased ICP/decreased CPP



Yes

Neurological Injury: Spinal Cord InjuryA. Places and secures patient in spinal immobilization to include C-collar (e.g. long spine board or vacuum spine board).

Performance TBD N/A 36M or with Permanent change of station(PCS), whichever comes first


Yes



BurnsA. Estimate depth of burn/TBSA burnedB. Administer IV fluids based on BSA burnedC. Documents intake/output on burn resuscitation flow sheetD. Performs burn wound managementE. Manages burn painF. Assists with acute care of patients with the following types of burns: electrical, inhalation, chemical, white phosphorus, petroleum burns and carbon monoxide poisoningG. Recognizes emergency burn syndromes: eschar and extremity/abdominal compartment



Yes

Pulmonary/thoracic injuries/disordersA. Pulmonary/thoracic trauma: open and tension pneumothorax, toxic inhalation (chlorine, hydrofluoric acid)B. Manages patient with flail chest



Yes

Cardiac injuryA. Blunt cardiac trauma (cardiac contusion)B. Cardiac tamponade



Yes

Abdominal TraumaA. Post-damage control surgery - monitors negative pressure wound therapy (wound vacuum/abdominal suction)B. Abdominal compartment syndrome1) Identifies patients at increased risk for intraabdominal hypertension/abdominal compartment syndrome2) Recognizes clinical manifestations of increasing intraabdominal pressure



Yes

Otologic InjuryA. Identifies patients at risk for otologic blast injuryB. Assists with care of patient with otologic



Yes

Pediatric Patients: Emergencies, IV access; fluid and medication administration; airway management, pediatric trauma and resuscitation



Yes

Provides Critical Care Nursing Care in Deployed location for the Following Issues

Blood/Blood Product Administration: Administers the following products:A. Fresh warm whole bloodB. Recombinant Factor VIIa (rFVIIa)C. Tranexamic Acid (TXA)D. Administers massive transfusion



Yes

Post-Anesthesia CareA. Recovers patient post- surgery/conscious sedationB. Calculates Aldrete scoreC. Determines when patient is ready for discharge from PACU



Pain/Anxiety ManagementA. Administers and monitors effect of analgesics, including intravenous morphine, fentanyl, dilaudidB. Administers and monitors effect of sedatives including propofol, midazolam, ketamineC. Sets up/administers medications via patient controlled analgesia (AMBIT Pain Pump)D. Assess for sedation level using RASS scaleE. Performs sedations vacation for mechanically ventilated patientsF. Administers and monitors effects of neuromuscular blockade



Yes



Advanced Cardiac Life Support (ACLS) Performance ACLS MED-R-1500 Q24M 16 hours Locally delivered by unit.


Basic Life Support (BLS) Knowledge/ Performance BLS MED-R-1503 Q24M 8 hours Locally delivered by unit.


Trauma Nurse Core Course (TNCC) Performance TNCC 6A-C4C(TNCC) Q 48M 72 hours Defense Medical Readiness Training Institute San Antonio, TX/ Can be delivered at select Militarty Training Facilities


Yes



Yes

Navy Trauma Training Center (NTTC) Performance NTTC B-6A-1013 Per Cycle 29 days (232 hours) LAC-USC Medical Center, 1200 North State Street, Room 6340, Los Angeles CA 90033


Chemical, Biological, Radiological, Nuclear, and Explosives (CBRNE) Emergency Preparedness Response Course (EMPRC) (Clinician)


NMETC-CBRNE-CC-2.0Q24M 8 hours Joint Knowledge Online (JKO)


Chemical, Biological, Radiological (CBR) Protective Equipment & Measures




Chemical, Biological, Radiological (CBR) Personal Protection and Decontamination


A-494-0008 Q36M 8 hours Gulfport; Port Hueneme Fleet Management & Planning System (FLTMPS)

International Trauma Life Support (ITLS) Knowledge ITLS B-300-4010 or 6A-C4C (ATLS)

Per Cycle 16 hours Multiple locations throughout US and at international training it


Joint Enroute Care Course (JECC) Performance JECC B-6E-1000 Initial 12 days (96 hours) Fort Rucker, AL Fleet Management & Planning System (FLTMPS)

Naval Aviation Survival Training Program (NASTP) Knowledge Non-Aircrew NASTP Training for Class 4 Aircraft with Devices (V-22)

B-4N-0101 Initial 8 hours Cherry Point, NC; Jacksonville, FL; Lemoore CA; San Diego, CA; Norfolk, VA; Patuxent River, MD; Pensacola, FL; Oak Harbor, WA








Readiness Criteria Group (Corps): Medical CorpsReadiness Criteria Specialty: Surgery, Subspecialty (Trauma)Navy Subspecialty Code/AQD or NEC 15C1/6CM









Metrics? Yes / No


Board Certification or Eligibility in General Surgery and Surgical Critical Care; Maintain clinical privileges for a Trauma Surgeon

Knowledge N/A N/A Initial / Recertification N/A N/A Joint Centralized Credentials Quality Assurance System (JCCQAS)

Yes

Knowledge assessment (written exam) Knowledge Trauma Knowledge, Skills, a N/A Q36M 4 hours Navy Medicine Readiness and Training Command (NMRTC)

TBD Yes

Clinical Currency General Surgery Threshold Knowledge, Skills, and Abilities (KSA) threshold 14, 000

Performance N/A N/A Rolling annual measure N/A N/A Military Health System Management Analysis and Reporting Tool (M2) - accessed through CarePoint

Yes

Trauma and Surgical Critical Care Clinical Currency Threshold minimum 20shifts/yr at L1 or 2 trauma center; admit > 35 patients w/ISS > 15

Performance N/A N/A Q12M N/A N/A Military Health System Management Analysis and Reporting Tool (M2) - accessed through CarePoint

Yes



Yes

Emergency War Surgery Course (EWSC) Performance EWSC B-6A-1003 Initial 24 hours Fort Sam Houston, TX Fleet Management & Planning System (FLTMPS)

Yes










Surgery, Subspecialty (Trauma) Enclosures (1)Page 32 of 49




A-494-0008 Once per career 8 hours Gulfport, MS or Port Hueneme, CA or Mobile Training Team (MTT)









Surgery, Subspecialty (Trauma) Enclosures (1)Page 33 of 49


Readiness Criteria Group (Corps): Medical CorpsReadiness Criteria Specialty: Ophthalmology, GeneralNavy Subspecialty Code/AQD or NEC 15G0









Metrics? Yes / No


Opthalmology Board Certification or Elegibility; Maintain clinical privileges for an ophthalmologist

Performance/Knowledge N/A N/A Initial/Recertification N/A N/A Joint Centralized Credentials Quality Assurance System (JCCQAS)

Yes

Clinical Curency Knowledge, Skills, and Abilities (KSA) threshhold Performance/Knowledge Clinical Currency KSA Threshold

N/A Rolling annual measure N/A N/A Military Health System Management Analysis and Reporting Tool (M2) - accessed through CarePoint

Yes

Ocular Trauma Course; Operating Room (OR) Performance/Knowledge Ocular Trauma Skills Laboratory

N/A Once every 3 years if no deployment or surgery min. not met

32 hours Uniformed Services University of Health Sciences (USUHS)

Army Training Requirements and Resources System (ATRRS)

Globe Repair Performance Ocular Trauma Skills Laboratory

N/A 1 per 3-yr cycle 32 hours Navy Medicine Readiness and Training Command (NMRTC), Regional Currency Site, Surgical Deployment Experience (5/year); Uniformed Services University of Health Sciences (USUHS) Ocular Trauma Course (1 every 3 years)


Yes

Orbit Repair Performance Ocular Trauma Skills Laboratory



Yes

Enucleation/Evisceration Performance Ocular Trauma Skills Laboratory



Yes

Manual Small Incision Cataract Surgery Performance Ocular Trauma Skills Laboratory

N/A 1 per 3-yr cycle 32 hours Navy Medicine Readiness and Training Command (NMRTC), Regional Currency Site, Surgical Deployment Experience (5/year)


Yes

Ophthalmology, General Enclosures (1)Page 34 of 49





Yes












Combat Casualty Care Course (C4) Performance C-4 B-6H-0001 Initial 56 hours TX, Fort Sam Houston Fleet Management & Planning System (FLTMPS)

Tactical Combat Care Course (TCCC) Performance TCCC B-300-4010 Q36M 24 hours Camp Pendleton, CA or Fort Sam Houston,TX






Ophthalmology, General Enclosures (1)Page 35 of 49


Readiness Criteria Group (Corps): Medical CorpsReadiness Criteria Specialty: Surgery, Subspecialty (Cardio Thoracic Surgery)Navy Subspecialty Code/AQD or NEC 15C1/6CD







Training Location Authoritative Data System Joint Expeditionary Scope of Practice (ESP)/Joint

Metrics? Yes / No


Clinical Currency Surgery Threshold - based on individualized determination of Consultant/Specialty Leader and Service Chief

Performance N/A N/A Rolling annual measure N/A N/A Military Health System Management Analysis and Reporting Tool (M2) - accessed through CarePoint

Yes

Board Eligible/Certified; Maintain clinical privileges for a Cardio Thoracic Surgeon

Knowledge Residency training N/A Initial/Recertification 8 hours - 16 hours N/A Joint Centralized Credentials Quality Assurance System (JCCQAS)

Yes




Yes














Surgery, Subspecialty (Cardio Thoracic Surgery) Enclosures (1)Page 36 of 49



Performance EWS, ASSET, or ASSET+ B-6A-1003 Initial 18 hours - 72 hours Various (Bethesda, MD; Fort Sam Houston, TX; San Diego, CA; Sacramento, CA)


Basic Endovascular Skills for Trauma (BEST) Performance BEST N/A N/A N/A Navy Medicine Readiness and Training Command (NMRTC)








Surgery, Subspecialty (Cardio Thoracic Surgery) Enclosures (1)Page 37 of 49


Readiness Criteria Group (Corps): Medical CorpsReadiness Criteria Specialty: Surgery, Subspecialty (Vascular)Navy Subspecialty Code/AQD or NEC 15C1/6CI









Metrics? Yes / No

Category-1:Core Practice/Clinical Currency – Fundamental training and skills, usually obtained through medical education and maintained through Medical Treatment Facility (MTF) experience and/or partnerships. This category of requirements links to the attainment of core practice, clinical currency, and Knowledge, Skills, and Abilities (KSA) Threshold for medical personnel.

Clinical Currency General Surgery Threshold 14,000 [Option B: Service specific case count (AF 240/yr w 70 "readiness; Navy/Army 100/yr w 50 "readiness")]

Performance N/A N/A Rolling annual measure N/A Navy Medicine Readiness and Training Command (NMRTC)


Yes

Board Eligible/Certified; Maintain clinical privileges for a Vascular Surgeon

Knowledge Vascular surgical fellowship/residency

N/A Initial/ Recertification Vascular surgical fellowship is 2 years after completion of a general surgery residency. * Vascular surgical residency is a 5 year residency in vascular surgery (not currently an endorsed training track in the US Navy)

N/A Joint Centralized Credentials Quality Assurance System (JCCQAS)

Yes

Knowledge Assessment (written exam) Knowledge TBD TBD Q24 months TBD TBD TBD Yes



Yes

Advanced Cardiac Life Support (ACLS) Performance ACLS MED-R-1500 Q24M 16 hours Navy Medicine Readiness and Training Command (NMRTC)





Surgery, Subspecialty (Vascular) Enclosures (1)Page 38 of 49















A-494-0008 Initial 8 hours Gulfport, MS or Port Hueneme, CA or Mobile Training Team (MTT)


Category-3:Platform Training for Readiness - Readiness Proficiency/Operational Platform – Team/Unit-level training specific to a platform or unit to which a Service member is assigned. This category of requirements links to the attainment of readiness proficiency and, as such, joint interoperability.




Surgery, Subspecialty (Vascular) Enclosures (1)Page 39 of 49


Readiness Criteria Group (Corps): Medical CorpsReadiness Criteria Specialty: Surgery, Subspecialty (Plastic)Navy Subspecialty Code/AQD or NEC 15C1/6CJ









Metrics? Yes / No


Board Eligible/Certified; maintain clinical privileges for a Plastic Surgeon Knowledge Oral and Written Board Preparation Course by American Society of Plastic Surgeons

N/A Initial/Recertification 24 hours N/A Joint Centralized Credentials Quality Assurance System (JCCQAS)

Yes

Clinical Currency Plastic Surgery 100 cases/year (40 currency cases): Currency cases should include soft tissue reconstruction, craniofacial, extremity reconstruction, and graft placement (skin, bone, fascia, dermis, fat, etc)

Performance N/A N/A Q12M N/A Navy Medicine Readiness and Training Command (NMRTC), TAA/MOU, ODE, Regional currency sites


Yes

Knowledge Assessment (written exam) Knowledge Recommend inclusion with General Surgery Knowledge Skills Abilities exam to ensure deployability as General Surgeon

N/A 3 years 4 hours Navy Medicine Readiness and Training Command (NMRTC)

TBD Yes


Advanced Trauma Life Support (ATLS) Performance ATLS 6A-C4C (ATLS) Q48M 40 hours San Antonio, TX Fleet Management & Planning System (FLTMPS) Yes




Pedicled and Free Tissue Flaps: perform a goal of 10 cases every 24 months. Includes local or distant flaps, pedicled or free, skin, muscle, fascia, or bone.

Performance Duke Flap Course: fresh cadaver flap dissection course

N/A (civilian course) no DON equivalence

Q24M 24 hours Navy Medicine Readiness and Training Command (NMRTC), TAA/MOU, ODE, Regional currency sites


Trauma Reconstruction: perform a goal of 10 cases every 24 months. Cases can include facial fracture, hand fracture, soft tissue coverage, trauma revision surgery.

Performance N/A N/A Q24M N/A Navy Medicine Readiness and Training Command (NMRTC), TAA/MOU, ODE, Regional currency sites


Surgery, Subspecialty (Plastic) Enclosures (1)Page 40 of 49


Advanced Cardiac Life Support (ACLS) Performance ACLS MED-R-1500 Q24M 16 hours Locally delivered by unit Fleet Management & Planning System (FLTMPS)


















Surgery, Subspecialty (Plastic) Enclosures (1)Page 41 of 49


Readiness Criteria Group (Corps): Medical CorpsReadiness Criteria Specialty: Urology, GeneralNavy Subspecialty Code/AQD or NEC 15J0









Metrics? Yes /No

Category-1: Core Practice/Clinical Currency - Urology Threshold 100 cases/year (60 currency cases): currency cases include adult or pediatric open or laparoscopic surgery of upper or lower urinary tract; scrotal surgery; reconstructive surgery of urinary tract; oncologic/extirpative surgery of genitourary system; pelvic floor reconstruction; transurethral and endoscopic surgery; and, other open or laparoscopic or exploratory procedures involving abdominal organs.

Board Eligible/Certified; Maintain clinical privileges for a Urologist Knowledge N/A N/A Initial/Recertification (every 10 years)

N/A N/A Joint Centralized Credentials Quality Assurance System (JCCQAS)

Yes

Knowledge Assessment Knowledge N/A N/A Q24M N/A N/A TBD YesCurrent License and Unrestricted Privileges in Urology Performance N/A N/A Q12M N/A N/A Military Health System

Management Analysis and Reporting Tool (M2) - accessed through CarePoint

Yes


Urologic Trauma Management: Knowledge of techniques for managing renal, ureteral, bladder and genital trauma. Knowledge of techniques of performing and interpretation of key imaging studies, including - cystogram; retrograde urethrogram; one shot IVP; and, demonstrate ability to radiographically stage renal injuries and diagnose bladder injuries via computed tomography (CT scan).

Knowledge/Performance TBD TBD Q24M EITHER 10 hours of direct care of trauma patients (Medical Treatment Facility (MTF) or alternative that includes Level 1 or 2 trauma center) or 10 hours CME Q24 months with focus on genitourinary trauma and reconstruction.

N/A TBD Yes

Advanced Trauma Life Support (ATLS) Performance ATLS 6A-C4C (ATLS) Per Cycle 40 hours San Antonio, TX Fleet Management & Planning System (FLTMPS)

Yes

Advanced Cardiac Life Support (ACLS) Performance ACLS MED-R-1500 Per Cycle 8 - 16 hours Navy Medicine Readiness and Training Command (NMRTC)


Yes

Chemical, Biological, Radiological, Nuclear, and Explosives (CBRNE) Emergency Preparedness Response Course (EMPRC) (Clinician)




Yes


Knowledge CBR and Hazmat Identification, Protective Equipment and Measures

CNE-CBR-001 Per Cycle N/A Navy eLearning Fleet Management & Planning System (FLTMPS)

Yes

Urology, General Enclosures (1)Page 42 of 49




A-494-0008 Per Cycle 8 hours Gulfport, MS or Port Hueneme, CA or Mobile Training Team (MTT)


Yes

Tactical Combat Care Course (TCCC) Performance TCCC B-300-4010 Per Cycle 24 hours Camp Pendleton, CA or Fort Sam Houston, TX


Yes





Urology, General Enclosures (1)Page 43 of 49


Readiness Criteria Group (Corps): Dental CorpsReadiness Criteria Specialty: Oral SurgeryNavy Subspecialty Code/AQD or NEC 1750









Metrics? Yes / No


Board Eligible/Certified; Maintain clinical privileges for an Oral Surgeon Knowledge N/A N/A Q10Y N/A N/A Joint Centralized Credentials Quality Assurance System (JCCQAS)

Yes

Clincial Currency w/ Conscious Sedation: Documentation of administration of Intravenous conscious sedation or general anesthesia of at least 20 cases.

Knowledge and Performance N/A N/A Q24M N/A Facility where Intravenous Conscious Sedation supported prior to deployment.


Yes

Clinical Currency w/ Oral and Maxillofacial Surgery: Advanced Head & Neck Hard and Soft Tissue Management to include documentation of participation in 4 major cases in categories of Orthognathic, Reconstruction, Deep Space Infection, Cosmetic, TMJ, or Trauma Surgery (requiring ORIF)

Knowledge and Performance N/A N/A Q24M N/A Facility with operating room capability where Major OMS cases in Orthognathic, Reconstruction, Deep Space Infection, Cosmetic, TMJ, or Trauma Surgery (requiring ORIF) are routinely supported.


Yes


Advanced Cardiac Life Support (ACLS) Knowledge ACLS MED-R-1500 Q24M 16 hours Locally delivered by unit. Fleet Management & Planning System (FLTMPS)

Yes



Yes












Oral Surgery Enclosures (1)Page 44 of 49






Oral Surgery Enclosures (1)Page 45 of 49


Readiness Criteria Group (Corps): Medical CorpsReadiness Criteria Specialty: Otolaryngology, GeneralNavy Subspecialty Code/AQD or NEC 15I0


both Knowledge and Performance (Practical Application Test)







Metrics? Yes /No


Maintain current, unrestricted medical license and clinical privileges in Otolaryngology

Knowledge N/A N/A Initial/Recertification N/A N/A Joint Centralized Credentials Quality Assurance System (JCCQAS)

Yes

Maintain Board Certification or Board Eligibility Knowledge Initial: Written and Oral Boards, then ongoing yearly MOC Modules and recertification exam every 10 years

N/A Initial/ MOC/Recertification Initial: Review course 40 hours, Oral and Written Exams 24 hours each. Ongoing: 5 hour module/year; every 10 years: 8 hour exam. Some Subspecialties have additional MOC requirements.

Initial exams require Temporary Additional Duty (TAD) Travel to test site which varies. Ongoing is online or local test site. Some subspecialties may require TAD to test site every 10 years in addition to ABOTO requirements. See ABOTO.org


Yes

Maintain Clinical Currency Otolaryngology Threshold when defined by Knowledge Skills Abilities Project Management Office (KSA PMO)

Performance Otolaryngology KSA Requirements

N/A Rolling Annual Measure N/A Navy Medicine Readiness and Training Command (NMRTC); Sites may elect Civilian Partnership or allow adequate ODE to Fulfill KSAs


Yes


Advanced Trauma Life Support (ATLS) Performance ATLS 6A-C4C (ATLS) Pre-Deployment only 40 hours San Antonio, TX Fleet Management & Planning System (FLTMPS) Yes

Advanced Cardiac Life Support (ACLS) Performance ACLS MED-R-1500 Q24M 16 hours NMRTC Fleet Management & Planning System (FLTMPS)














Otolaryngology, General Enclosures (1)Page 46 of 49






Otolaryngology, General Enclosures (1)Page 47 of 49


Readiness Criteria Group (Corps): Medical CorpsReadiness Criteria Specialty: Neurological Surgery, GeneralNavy Subspecialty Code/AQD or NEC 15D0





certification and training renewal e.g. "Per Cycle"

or "Q36M")


hours) away from the MTF that it takes to

complete the training)





Board eligible and actively engaged in certification process, or board certified and actively enrolled in MOC process with ABNS; Maintain clinical privileges for an Neurological Surgeon

Knowledge N/A N/A Initial/Recertification 144 hours Variable Joint Centralized Credentials Quality Assurance System (JCCQAS)

Yes

Craniotomy Performance N/A N/A Q12M N/A Primary site of practice/credentials


Yes

Spinal instrumentation Performance N/A N/A Q12M N/A Primary site of practice/credentials


Yes

ICP management Performance N/A N/A Q12M N/A Primary site of practice/credentials


Yes




Yes

Emergency War Surgery Course (EWS) Knowledge EWS B-6A-1003 Initial 24 hours TX, Fort Sam Houston Fleet Management & Planning System (FLTMPS)

Yes

Neurological Surgery, General Enclosures (1)Page 48 of 49


Combat Casualty Care Course (C4) Knowledge C4 B-6H-0001 Initial 56 hours TX, Fort Sam Houston Fleet Management & Planning System (FLTMPS)













Expeditionary Medical Facilities (EMF) Build Team Training Performance EMF PHASE IIA B-300-2406 Per Cycle 40 hours CA, Camp Pendleton Fleet Management & Planning System (FLTMPS)


Performance EMF PHASE IIB B-300-2407 Per Cycle 40 hours CA, Camp Pendleton Fleet Management & Planning System (FLTMPS)

Neurological Surgery, General Enclosures (1)Page 49 of 49